| NPI | 1881642593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 19024714) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA 51534) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-09-12 |